Bath PUVA versus oral PUVA in the treatment of chronic palmo-plantar psoriasis

Abstract

<p><strong>Background: </strong>Psoriasis is a chronic, recurring inflammatory disease of the skin with an unpredictable course and variable prognosis. Palms and/or soles are involved in 10% to 21.1% of all psoriasis cases. Palmo-plantar psoriasis is a therapeutically challenging condition that can significantly impact quality of life. It is frequently resistant to traditional topical therapies, such as potent steroids, calcipotriol and anthralin but show good response to photochemotherapy (PUVA).<strong> </strong>Aim of the study was to compare the efficacy and safety of bath PUVA versus oral PUVA in patients with chronic palmo-plantar psoriasis.<strong></strong></p><p><strong>Methods: </strong>This randomized clinical open trial was conducted in the department of dermatology and venereology, BSMMU, Dhaka from 1<sup>st</sup> September 2007 to 28<sup>th </sup>February 2008. Patients clinically diagnosed with chronic palmo-plantar psoriasis were selected by simple random sampling. A sample size of 50 patients was taken, 25 for bath PUVA and 25 for oral PUVA group. Psoriasis area and severity index (PASI) score was used to determine the percentage of reduction of Palmo-plantar psoriasis in both groups. Data were analysed with computer-based program SPSS version.</p><p><strong>Results: </strong>Reduction of psoriasis at 1<sup>st</sup> follow-up in bath PUVA and oral PUVA were 29.85±8.95 and 31.93±11.55 respectively. At 2<sup>nd</sup> follow-up were 85.86±7.33 and 28.48±39.32 respectively. Significantly higher improvement was observed in Bath PUVA group than oral PUVA group, both at 1<sup>st</sup> and 2<sup>nd</sup> follow-up (p=0.001).</p><p><strong>Conclusions:</strong> Bath PUVA was significantly more effective at reducing Palmo-plantar psoriasis than oral PUVA.</p>